Nonbacterial thrombotic endocarditis
Specialty	Cardiology
Treatment	Anticoagulation

Nonbacterial thrombotic endocarditis (NBTE) is a form of endocarditis in which small sterile vegetations are deposited on the valve leaflets. Formerly known as marantic endocarditis, which comes from the Greek marantikos, meaning "wasting away".^[1] The term "marantic endocarditis" is still sometimes used to emphasize the association with a wasting state^[2] such as cancer.^[3]

Risk factors[edit]

Marantic vegetations are often associated with previous rheumatic fever. Other risk factors include:^{[citation needed]}

• hypercoagulable states
• malignant cancers, especially mucin-producing adenocarcinomas (most commonly associated with pancreatic adenocarcinomas)
• systemic lupus erythematosus: Referred to as Libman-Sacks endocarditis
• trauma (e.g., catheters)

Valve predilection[edit]

The disease affects the valves with following predilection: mitral valve > aortic valve > tricuspid valve > pulmonary valve^[4]

Histopathology[edit]

Grossly, vegetations form along lines of valve closure and are generally symmetric with a smooth or verrucoid (warty) texture. Histologically, lesions are composed of fibrin^[5] (eosinophilic) and platelets but, unlike bacterial etiologies, contain little evidence of PMNs, microorganisms or inflammation.^{[citation needed]}

Diagnosis[edit]

Due to the non-invasive nature of NBTE, clinical examination may or may not reveal a new murmur. An embolic stroke may be the first feature to suggest diagnosis of NBTE. An echocardiogram may be used to further assess for valvular lesions.^{[citation needed]}

References[edit]

External links[edit]